HomeMy WebLinkAboutDrain Layers Permit 64 Clinton Drive (2) �+ TOWN OF ;S0 WI N DSOR
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DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT 239
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 6!� Cm- `!4.R '•�Iff! 17.E t 91
on the
?4 1 side, between l'f r 1° 'x C a .-mood Driv*
at premises owned .'4
whose address is M'="_a'g
and to Lay House Drain, Repair House Drain, Lay Main, Other
for " t " .a .=s occupancy or use,
with Ono ?.i Family Units, with acres.
Type of Sewage to be connected under this permit:
'SANITARY SEWAGE? INDUSTRIAL WASTES, OR
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. P�` t'# Permit will expire on. 19 .F)--
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS Jr -kt er 1-- ',;Ar, anjf€Y aad bees,
" g
Signed
Connection Charge Paid I °>. f Licensed Drain Layer
4 (Sig) Issued by. ;•:'E Ore
Tax Collector
Permit Fee: Paid
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
K i t
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N
C
a
l
u 3"
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK Soogt-
DATE PERMIT PIPE
INSTALLER
INSPECTOR Jrt7s FR,. " DRAWN BY